View full sizeJeff Devine is a graduate of the Palmer College of Chiropractic.Devine Chiropractic

A Portland mom asked Omamas to write about chiropractic for kids, mentioning a chiropractor she recently met. "He says he gets amazing results on things such as colic," she wrote of Jeff Devine of Devine Chiropractic in Raleigh Hills.

Chiropractic is considered alternative medicine. The American Chiropractic Association defines it as "a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health."

Adults typically visit chiropractors for back, neck and joint pain and headaches. Treatments often consist of manipulating joints and/or vertebrae, with some massage in some cases.

Chiropractors do not attend medical school but typically have undergone premed studies, attended four years of chiropractic college, received state licenses and passed national board examinations.

View full sizeElise Hewitt is a doctor of chiropractic and craniosacral therapist in Portland.Portland Chiropractic Group

Chiropractic and allopathic: "Chiropractic and traditional allopathic care" -- mainstream medicine -- "are complementary forms of healthcare," Hewitt said. She described chiropractic as the first rung on "the continuum of care." Chiropractors represent "the lowest level of invasiveness on that ladder," she said.

Hewitt said she believes chiropractic and pediatric medicine dovetail well. "I actually require all our patients to have a relationship with a pediatrician or a pediatric naturopath," she said. "I get a fair number of referrals from pediatricians."

Shih said he has referred some teenagers to chiropractors for minor neck or back pain but prefers not to refer children or infants.

"The pediatric spine is much more flexible than the adult spine," he said. "You can actually stretch somebody's spine and cause a spinal cord injury in, say, a small child, whereas you couldn't do that in an adult because our spine is so stiffened."

Shih said he has not treated a child "with a specific untoward effect of a chiropractic maneuver."

Hoffman said he would advise parents considering a chiropractor "to think very carefully" and make sure the chiropractor has advanced training of some sort.

View full sizeDoernbecher pediatrician Ben Hoffman is a graduate of Harvard Medical School.OHSU

"I can back up what I do with some sense of best-practice recommendations," he said. "A lot of complementary alternative medicine, especially for kids, has not had the luxury of the same level of data to support it."

Devine said there is plenty of research to back up the effectiveness of chiropractic. He added, "We have a lot of people that come in and get results in here. That's evidence. ... Evidence has multiple legs and a big proportion of that is clinical outcomes. We get amazing clinical outcomes."

He said parents can find chiropractors who have taken extra courses in pediatric adjusting, as well as prenatal and postnatal specialties.

Hewitt said that when pediatricians are skeptical of chiropractors, "usually it's just simply a lack of understanding or a misunderstanding of what chiropractic is and how chiropractors can positively affect health. ... As soon as they understand what chiropractic's about and how safe it is, they're willing to get on board."

Why parents go: Hewitt and Devine said parents take children to chiropractors for both general wellness care and specific health issues.

Issues such as an inability to nurse might seem unrelated to joints and muscles, she said. But if joints are locked up, that can irritate the nervous system, and if the nerve controlling a baby's tongue is irritated, the baby can't suck properly, she said. A chiropractor can go to the root of the problem and clear the blockage, she said.

Devine estimated that about 20 percent of the patients at his practice are children. He frequently sees them for falls or improper gaits, but parents also bring in kids for problems such as ear infections and for preventive care -- "to be adjusted and stay healthy."

Shih said of taking kids to chiropractors for wellness care, "It doesn't seem like it would be something that would be harmful as long as things aren't being addressed that shouldn't be. But then whether or not it does any good ..." He asks his patients' parents to let him know if they see a chiropractor and advises them to find one who will be as gentle as possible.

Hoffman said the bottom line is that for most pediatric chiropractic care, "there has not been a real consistent benefit ... when it's been studied, the claims really don't play out."

Time and cost: Hewitt said a specific problem typically requires four weeks of treatment, with an initial 45- to 60-minute visit that includes a health history and comprehensive exam and shorter followup visits. A typical visit costs about $55, she said; her practice offers sliding scales.

Devine Chiropractic's website offers new patient and family package discounts off what are listed as $265- and $250-per-person values. Devine noted that his patients are often voting with their wallets, paying for chiropractic care out of pocket.

Research: Parents looking for independent large-scale research on the effectiveness of pediatric chiropractics won't find much. A 2000 article in JAMA Pediatrics noted the need for such studies, saying, "Pediatric chiropractic care is often inconsistent with recommended medical guidelines."

A 2009 USA Today article quoted Hewitt as saying she would welcome more high-level studies but is "comfortable treating kids based on preliminary research, 100 years of chiropractic history and her own experiences." The same article cited a 2007 safety study that found a few serious pediatric injuries and one death, but said the study's author found no proof that spinal manipulation caused the injuries.